Prescribe naloxone to all patients at high risk of opioid overdose, recommends HHS

Prescribe or co-prescribe naloxone to all patients at high risk of opioid complications or overdose, recommends HHS

Adm. Brett P. Giroir, MD, assistant secretary for health and senior advisor for opioid policy on behalf of U.S. Department of Health & Human Services (HHS) has released guidance for healthcare providers and patients. According to new recommendations, naloxone – the opioid overdose reversal drug – can help save lives and should be prescribed to all patients at risk for opioid complications, including overdose.

Naloxone is an FDA-approved medication that can save a person’s life when administered during an opioid overdose. Naloxone reverses the effects of opioids, such as stopped or slowed breathing. However, for naloxone to revive individuals who have experienced an opioid overdose, it must be in the right hands at the right time and administered within minutes of life-threatening symptoms. Naloxone is available in a variety of forms (nasal spray, injection, auto-injector); and at least one form is covered by most health insurance plans, including Medicaid and Medicare.

In order to reduce the risk of overdose deaths, the guidance released reinforcess and expands upon prior CDC guidelines. It recommends that Clinicians should also educate patients and those who are likely to respond to an overdose, including family members and friends, on when and how to use naloxone in its variety of forms. They prescribe or co-prescribe (prescribed in conjunction with additional medication) naloxone to individuals at risk for opioid overdose, including, but not limited to: individuals who are on relatively high doses of opioids, take other medications which enhance opioid complications or have underlying health conditions. By co-prescribing, or prescribing naloxone to at risk individuals, patients, and their loved ones could be better equipped for possible complications of overdose, including slowed or stopped breathing

“Given the scope of the opioid crisis, it’s critically important that healthcare providers and patients discuss the risks of opioids and how naloxone should be used in the event of an overdose,” said Adm. Giroir. “We have begun to see some encouraging signs in our response to the opioid crisis, but we know that more work is required to fully reverse the decades-long epidemic. Co-prescribing naloxone when a patient is considered to be at high risk of an overdose, is an essential element of our national effort to reduce overdose deaths and should be practiced widely.”

“Promoting the targeted availability and distribution of overdose-reversing drugs is one of the five pillars of HHS’s comprehensive, science-based strategy for the opioid epidemic,” said Health and Human Services Secretary Alex Azar. “This new guidance reflects our commitment to ensuring those who need overdose-reversing drugs have them and provides practical steps that clinicians, patients, and the public can take to reduce the risk of an overdose.”

In April 2017, HHS announced its 5-Point Strategy to Combat the Opioids Crisis. Those efforts include: better addiction prevention, treatment, and recovery services; better data; better pain management; better targeting of overdose-reversing drugs; and better research. In April 2018, Surgeon General VADM Jerome Adams issued an unprecedented advisory encouraging more individuals, including family, friends, and those who are personally at risk for an opioid overdose to carry naloxone. Today’s guidance will bolster HHS’ ongoing efforts to combat the opioid crisis and expand the use of naloxone.